Pseudomyxoma peritonei (PMP), also known as jelly belly, is an extremely rare condition that usually develops from cancers of the appendix. Unlike other cancers that spread to other organs and areas of the body, pseudomyxoma peritonei remains confined to the abdomen but may cause symptoms due to massive distension and pressure.
How is Pseudomyxoma Peritonei treated?
The management of pseudomyxoma peritonei can include:
- People with newly diagnosed and early PMP may be monitored using a 'watch and wait' policy. This is applicable to patients who have had a perforated appendix tumour where there is some mucinous peritoneal involvement but uncertainty as to whether PMP will develop. Surgery may be required some months to years later, though many avoid the need for further treatment.
Complete Cytoreduction (The Sugarbaker technique)
- This involves removing the complete tumour, stripping the lining of the abdomen known as the peritoneum and operating on the small intestine, colon, rectum, liver, gall bladder, spleen, omentum, and in women the ovaries and uterus.
- The abdomen is then washed out with hot chemotherapy for one hour.
- The average length of an operation for complete tumour removal is 10.5 hours.
Maximal Tumour Debulking
- This involves an extended right hemicolectomy (in some cases a total colectomy with an ileostomy), a greater omentectomy often with a splenectomy and removal of the uterus and ovaries in women. where as much as possible of the mucinous ascites is removed together with easily removable structures such as ovarian masses and parts of the omentum.
- The operation time is 4 to 6 hours.
Following surgery, patients are nursed in the intensive care unit before returning to the ward. The stay in hospital is approximately three weeks, usually with relatives staying nearby for this time.
The care of the patient is complex and requires the involvement of specialist nurses, physiotherapists, pharmacists and nutritionists.
Basingstoke and North Hampshire Hospital is a National Specialist Centre
Basingstoke and North Hampshire Hospital is one of 2 National Specialist Centre’s for pseudomyxoma peritonei, commissioned by National Commissioning Group (NCG) on behalf of United Kingdom residents, for the assessment and treatment of pseudomyxoma peritonei.
The centre forms part of the colorectal unit, and has built upon the expertise of this unit in the management of complex rectal cancer surgery. Since its establishment in 2000 the centre has built up a strong team of individuals with specialist skills in the care of patients with pseudomyxoma peritonei.
Patients are referred to the unit for assessment and treatment from all over the United Kingdom. Referrals can be from your GP or your consultant if you are being treated within a hospital.
The specialised Basingstoke colorectal management and analysis computer system has been tailored to the specific requirements of the pseudomyxoma service. These systems facilitate collection and analysis of data to support high quality clinical research, and to integrate this research into clinical practice to improve outcomes for patients with pseudomyxoma peritonei and colorectal cancer.
The Role of the National Commissioning Group (NCG)
The role of the NCG is to commission services on a national basis for the population of England (and, in some cases, of other countries) for rare conditions to uphold the principles of the NHS with regard to access to what can be complex and expensive treatments.www.ncg.nhs.uk
Donations to the Pseudomyxoma research fund can be made payable to: Hampshire Hospitals Charity (Registered Charity 1060133) (Fund No. 4643)